U.S. ‘patient one’ spurs one of many COVID-19 drug trials

Man in suit standing in hospital hallway (© Ted S. Warren/AP Images)
Dr. George Diaz treated the first person with a confirmed case of COVID-19 in the United States. That treatment spurred studies of potential COVID-19 treatments. (© Ted S. Warren/AP Images)

Dr. George Diaz, an infectious diseases expert at Providence Regional Medical Center in Washington state, recently spoke of treating the first confirmed patient with COVID-19 in the United States.

The patient was admitted to the Everett, Washington, hospital with symptoms typical of COVID-19 — fever, cough and fatigue. One week into his hospitalization, and after he had developed pneumonia, the patient was given the experimental drug remdesivir.

Previously tested in healthy volunteers during the Ebola outbreak, remdesivir seemed safe, although not very effective against that virus, Diaz said. But he said that within 24 hours of receiving the drug, the COVID-19 “patient one” was able to come off of oxygen support. Since then, the patient has “done quite well,” said Diaz.

Hospital sign and building (© Jason Redmond/AFP/Getty Images)
Providence Regional Medical Center in Everett, Washington, is shown in January. (© Jason Redmond/AFP/Getty Images)

Promising trials

Soon after treating “patient one,” Providence Regional Medical Center launched a clinical trial of remdesivir (made by the U.S. firm Gilead Sciences), which found that patients who receive the drug therapy during their first 10 days of symptoms do better than those who do not. The U.S. National Institutes of Health also set up a remdesivir trial, and its data shows that the recovery time for COVID-19 patients treated with the drug is reduced by roughly four days.

The Food and Drug Administration (FDA) has granted emergency use of remdesivir therapy in patients with severe pneumonia.

Graphic showing U.S. drug trials for COVID-19, 144 underway, 457 planned (State Dept./M. Rios)
(State Dept./M. Rios)

Testing other therapies

So far, there are 144 trials of potential drug therapies for COVID-19 underway in the United States, including 72 clinical trials with FDA oversight, according to the FDA. Another 457 trials are being planned.

The World Health Organization’s International Clinical Trials Registry Platform lists 2,739 clinical trials for COVID-19 therapies worldwide, a figure that reflects both ongoing and completed trials.

Researchers studying some of these therapies are also releasing promising, if preliminary, results.

A phase II clinical trial in Hong Kong found that a combination of three drugs — interferon beta-1b (made by Germany’s Bayer Company), lopinavir/ritonavir (made by the U.S. firm AbbVie) and ribavirin (made by the Swiss firm Roche Products Limited) — is successful in treating mild to moderate cases of COVID-19.

The trial results, published in the medical journal the Lancet, show that the three-drug cocktail shortens the time during which the virus is detectable in a person’s body and transmissible to others. The treatment also shortens hospital stays.

Lead researcher Dr. Yuen Kwok-yung, of the University of Hong Kong, told Medical News Today that interferon beta-1b may be a key component of the three-drug therapy, but he struck a cautionary note. “We must confirm in larger, phase III trials that interferon beta-1b alone or in combination with other drugs is effective in patients with more severe illness,” in whom the virus has had more time to replicate.

For his part, Diaz said that people should follow the social-distancing guidelines of public health experts. Social distancing is still the “most effective prevention for COVID-19,” he said.